title: Serial changes in ischemic lesion volume and neurological recovery after t-PA therapy.
abstract: OBJECTIVE
  The present study investigated the relationship between serial changes in ischemic lesion volume (ILV) and neurological recovery after t-PA therapy.
  
  
  METHODS
  A total of 110 consecutive patients with ICA and MCA occlusion on MRA treated with t-PA within 3 h of onset were prospectively studied. MRI including MRA, DWI, and FLAIR, was performed before, 1 h, 24 h, and 7 days after t-PA infusion to measure serial changes in ILV.
  
  
  RESULTS
  The mean (SD) values of ILV at baseline, 1 h, 24 h, and 7 days after t-PA infusion were 30.2 (61.0), 48.1 (76.3), 98.3 (125.3), and 125.9 (149.8) cm(3), respectively. Recovery at 7 days was remarkable in 46 patients and good in 21 patients. Change in NIHSS score (baseline NIHSS minus NIHSS at 7 days) correlated with ΔILV (ILV at 7 days minus baseline ILV) (r=0.611, P<0.0001). Sensitivity and specificity curve analysis demonstrated that a cutoff value for ΔILV of 40 cm(3) (sensitivity, 80.0%; specificity, 79.3%) indicated remarkable recovery, and that 80 cm(3) (78.8% and 76.3%) indicated good recovery.
  
  
  CONCLUSIONS
  The thresholds of ΔILV enlargement for remarkable and good recovery after t-PA therapy were 40 and 80 cm(3), respectively.
authors.affiliation: Department of Stroke Medicine, Kawasaki Medical School, Okayama, Japan. kimurak@med.kawasaki-m.ac.jp
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kimura
authors.forename: Yuki
authors.initials: Y
authors.lastname: Sakamoto
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Iguchi
authors.forename: Kensaku
authors.initials: K
authors.lastname: Shibazaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000187:drug effects / Q000473:pathology; D002545:Brain Ischemia / Q000188:drug therapy* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging / Q000639:trends; D008297:Male; D011446:Prospective Studies; D020127:Recovery of Function / Q000187:drug effects* / Q000502:physiology; D020521:Stroke / Q000188:drug therapy* / Q000473:pathology*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D010959:Tissue Plasminogen Activator